Diarrhea

Diarrhea is a universal experience, though many people have different definitions of it. The World Health Organization has defined diarrhea as stools that if placed into a container, would take the shape of that container. Diarrhea can be frequent or occur just once or twice a day.

Diarrhea in children may be caused by a number of different problems. Infections are the most common cause of short term, or acute, diarrhea. We call this acute gastroenteritis (nothing really cute about it though). Infections causing gastroenteritis often starts with vomiting and fever and then progresses to diarrhea. Infectious diarrhea typically lasts only a few days but can last up to 14 days. Most infections are caused by viruses and get better without antibiotics.

If diarrhea is causing signs of dehydration like dry lips or mouth, excessive thirst, or decreased urination, then it is important to rehydrate the child. Ask your pediatrician how to do this. Your child may need to see your pediatrician for an evaluation if you suspect diarrhea. Pediatric gastroenterologists (like our doctors at CCDHC) are rarely needed to assist the pediatricians to treat short term diarrhea (2 weeks or less).

Diarrhea that lasts longer than two weeks may indicate other problems besides viral infection. Some infections, like Clostridium difficile and parasitic infections, may cause persistent diarrhea. [Parasites, tiny microscopic germs, are common in Georgia.] These may be detected with stool tests that your pediatrician can order before referring you to a specialist.

If the stool tests for infections don't provide an answer, there may be something else going on. You should contact your pediatrician if there are warning signs like blood in the stool (could be a bacterial infection or a colitis), persistent vomiting (especially concerning is if the vomiting includes blood or bile), weight loss or severe abdominal pain.

Our doctors are experts in the evaluation and treatment of diarrhea diseases. We will review your child's history, perform a physical examination and decide if further testing or treatment is indicated. Tests may include stool studies (it may help to bring a fresh stool sample with you to the appointment if possible) or blood tests. Sometimes a procedure called upper endoscopy or colonoscopy is necessary.

Some of the disorders or diseases that can cause diarrhea are lactose intolerance (gets better off of milk products), food allergy, celiac disease, irritable bowel syndrome, Crohn's disease or Ulcerative Colitis. CCDHC offers 10 pediatric gastroenterologists that specialize in the evaluation and treatment of diarrhea.

Additional information can be found at these websites:
http://www.naspghan.org/user-assets/Documents/pdf/diseaseInfo/Diarrhea-E.pdf

http://www.cincinnatichildrens.org/health/info/abdomen/diagnose/acute-
diarrhea.htm

http://www.naspghan.org/sub/ACUTE_AND_CHRONIC_DIARRHEA.htm

http://www.aboutkidsgi.org/Diarrhea.html